Genetic variants of ApoE and ApoER2 differentially modulate endothelial function

It is poorly understood why there is greater cardiovascular disease risk associated with the apolipoprotein E4 (apoE) allele vs. apoE3, and also greater risk with the LRP8/apolipoprotein E receptor 2 (ApoER2) variant ApoER2-R952Q. Little is known about the function of the apoE–ApoER2 tandem outside of the central nervous system. We now report that in endothelial cells apoE3 binding to ApoER2 stimulates endothelial NO synthase (eNOS) and endothelial cell migration, and it also attenuates monocyte–endothelial cell adhesion. However, apoE4 does not stimulate eNOS or endothelial cell migration or dampen cell adhesion, and alternatively it selectively antagonizes apoE3/ApoER2 actions. The contrasting endothelial actions of apoE4 vs. apoE3 require the N-terminal to C-terminal interaction in apoE4 that distinguishes it structurally from apoE3. Reconstitution experiments further reveal that ApoER2-R952Q is a loss-of-function variant of the receptor in endothelium. Carotid artery reendothelialization is decreased in ApoER2^−/− mice, and whereas adenoviral-driven apoE3 expression in wild-type mice has no effect, apoE4 impairs reendothelialization. Moreover, in a model of neointima formation invoked by carotid artery endothelial denudation, ApoER2^−/− mice display exaggerated neointima development. Thus, the apoE3/ApoER2 tandem promotes endothelial NO production, endothelial repair, and endothelial anti-inflammatory properties, and it prevents neointima formation. In contrast, apoE4 and ApoER2-R952Q display dominant-negative action and loss of function, respectively. Thus, genetic variants of apoE and ApoER2 impact cardiovascular health by differentially modulating endothelial function.Cardiovascular disease risk is modified by common genetic variants of apolipoprotein E (apoE) and its receptor apolipoprotein E receptor 2 (ApoER2), which is a member of the LDL receptor family. Compared with the most common allele apoE3, individuals with the apoE4 allele have an increased risk of atherosclerosis and coronary heart disease (1, 2). The LRP8 gene, which encodes ApoER2, is a major gene locus for premature atherosclerosis and acute myocardial infarction identified in four independent human populations. In particular, homozygous carriers of the ApoER2-R952Q variant have a twofold increased risk of these conditions (3–5). ApoER2-R952Q also has an additive effect with apoE4, with the combined genotype QQ/E4 showing a 3.9-fold greater susceptibility to cardiovascular disease (5). ApoER2 polymorphism-associated risk is independent of cholesterol levels (3–5), and although apoE4 may impact LDL abundance (2), there is also evidence that apoE4-associated risk goes well beyond changes in lipoprotein status (6–9). Whereas there is considerable understanding of the biology of the apoE–ApoER2 tandem in the central nervous system and in Alzheimer’s disease (10), the basis for the cardiovascular impact of the receptor and apoE variants remains unclear.Our prior work demonstrated that ApoER2 is expressed in endothelial cells, where it plays a critical role in the pathogenesis of the antiphospholipid syndrome (APS) (11). The receptor is enriched in caveolae/lipid rafts in which signaling molecules regulating endothelial NOS (eNOS) are compartmentalized (12, 13). We now know that in APS, antiphospholipid antibody recognition of the cell surface protein β2-GPI on endothelial cells promotes β2-GPI dimerization and interaction with the extracellular domain of ApoER2, causing the activation of PP2A and eNOS antagonism. The resulting decrease in bioavailable NO underlies APS-related thrombosis (11). However, the normal function of the receptor in endothelium, and whether and how it modulates apoE actions on endothelium, are unknown.In addition to regulating thrombogenesis, eNOS-derived NO plays a major role in cardiovascular protection via promotion of the integrity of the endothelial cell monolayer and attenuation of endothelial cell–leukocyte adhesion (13). Recognizing that eNOS enzymatic activity is both positively and negatively modulated by signaling molecules in endothelial caveolae/lipid rafts (14), to better understand the biology of ApoER2 in endothelium we hypothesized that apoE3 binding to the receptor activates eNOS. Experiments were performed in cell culture and in mice to test this hypothesis and to determine whether genetic variants in apoE or ApoER2 disrupt this process and thereby adversely impact endothelial function.     

Montelukast modifies simvastatin-induced myopathy and hepatotoxicity

Montelukast (MNK) has prominent anti-inflammatory and antioxidant activities. It can protect the liver in different hepatotoxic models in animals. Simvastatin (SMV) is one of commonly used lipid lowering drugs for treatment of dyslipidemia in order to reduce cardiovascular disease. It has severe side effects such as myopathy and hepatotoxicity. The aim of the present study is to investigate the possible effect of MNK on SMV-induced myopathy and hepatotoxicity. Four groups of male rats: control group which received saline via stomach tube, MNK treated group (received 10 mg/kg/day MNK via stomach tube), SMV treated group (received 30 mg/kg/day SMV via stomach tube), and MNK + SMV (combination) group which received both MNK and SMV. All animals were treated for 14 days before obtaining blood and tissue samples. SMV has both hepatotoxic effects and myopathy. SMV caused a significant increase in myoglobin, creatinine kinase, ALT, AST, ALP, and bilirubin but, it decreased total proteins, globulin and albumin levels. Co-treatment of SMV and MNK increased the antioxidant activity significantly. MNK modifies partially the myopathic changes and hepatotoxic effect of SMV. Co-administration of MNK and SMV decreased their toxic potentials on the liver, skeletal muscles, and kidney. They have antioxidant activities when given together that produce muscle and hepatic protective effects.     

Simulation-based training in maxillofacial surgery: are we going to be left behind?

Simulation is an important way both to optimise a trainee’s learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees’ opinions of it was made in February 2018, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. A total of 45 of the 57 trainees who replied agreed that simulation-based training would be beneficial in maxillofacial surgery, particularly with regard to maxillofacial surgical emergencies. A total of 54 of the 57 also agreed that simulation-based training would be a useful adjunct to their clinical training. However, most of the simulation-based courses available were priced beyond the budgets available to UK-based trainees for study, although funding changed in April 2018. While other surgical disciplines have adopted simulated clinical teaching and its benefits, maxillofacial surgery has limited the use of all types of formal simulation. Surgical simulation training is increasingly being used to complement the traditional surgical apprenticeship in other specialties, and ours needs to consider ways in which we can use it, given that trainees within the specialty think that it would be useful. Other specialties have shown that there is good transfer of skills from simulation to the actual clinical operating environment, and this increases satisfaction, decreases morbidity, and reduces the time required for intraoperative teaching.     

Massive isotopic effect in vacuum UV photodissociation of N2 and implications for meteorite data

Nitrogen isotopic distributions in the solar system extend across an enormous range, from −400‰, in the solar wind and Jovian atmosphere, to about 5,000‰ in organic matter in carbonaceous chondrites. Distributions such as these require complex processing of nitrogen reservoirs and extraordinary isotope effects. While theoretical models invoke ion-neutral exchange reactions outside the protoplanetary disk and photochemical self-shielding on the disk surface to explain the variations, there are no experiments to substantiate these models. Experimental results of N₂ photolysis at vacuum UV wavelengths in the presence of hydrogen are presented here, which show a wide range of enriched δ¹⁵N values from 648‰ to 13,412‰ in product NH₃, depending upon photodissociation wavelength. The measured enrichment range in photodissociation of N₂, plausibly explains the range of δ¹⁵N in extraterrestrial materials. This study suggests the importance of photochemical processing of the nitrogen reservoirs within the solar nebula.Nitrogen isotopic analyses of meteorites, terrestrial planets, atmospheres of giant planets and their moons, solar wind, comets, and interplanetary dust particles (1) may advance understanding of volatile chemistry and prebiotic processes in the early solar system.     

Pr3+ doping at the A-site of La0.67Ba0.33MnO3 nanocrystalline material: assessment of the relationship between structural and physical properties and Bean–Rodbell model simulation of disorder effects

Bulk nanocrystalline samples of (La_1−xPr_x)_0.67Ba_0.33MnO₃ (0.075 ≤ x ≤ 0.30) manganites with a fixed carrier concentration are prepared by the sol–gel based Pechini method. Rietveld refinement of the X-ray diffraction patterns, shows the formation of single-phase compositions with rhombohedral symmetry. Upon Pr³⁺ doping at the A-site, the unit cell volume and the B–O–B bond angles are reduced. FTIR spectra present a prominent absorption peak of the in-phase stretching mode (B_2g mode) rising from the vibration of the Mn–O bond. Raman spectra at room temperature reveal a gradual shift toward lower frequencies in (E_g) phonon mode with increasing Pr³⁺ concentration. The M(T) measurements shows a clear ferromagnetic (FM)–paramagnetic (PM) phase transition with increasing temperature. An increase in resistivity and activation energy and a decrease in the metal–semiconductor transition (T_M–SC) and Curie temperatures (T_C) was observed as a consequence of Pr³⁺ doping. The results are discussed according to the change of A-site-disorder effect caused by the systematic variations of the A-site average ionic radius 〈r_A〉 and A-site-cation mismatch σ², resulting in the narrowing of the bandwidth and the decrease of the mobility of e_g electrons. The magneto-transport behavior in the whole measured temperature and a magnetic field can be described by a percolation model, which is in agreement with the limited experimental data of the samples for x = 0.075, 0.15 and 0.30. The experimental results confirm that A-site substitution with Pr³⁺ destroys the Mn³⁺–O²⁻–Mn⁴⁺ bridges and weakens the double exchange (DE) interaction between the Mn³⁺ (t³_2ge¹_g, S = 2) and Mn⁴⁺ (t³_2ge⁰_g, S = 3/2) ions. On the other hand, the Bean and Rodbell model has been successfully used to simulate the magnetization data of the samples with x = 0.15 and x = 0.22. The random replacement of La³⁺ by Pr³⁺ is shown to induce more disorder in the system, which is reflected in the increase of the fitted disorder parameter and spin value fluctuation. At a temperature close to room temperature, the maximum magnetic entropy change (ΔS_Max) and the relative cooling power (RCP) of La_0.52Pr_0.15Ba_0.33MnO_2.98 are found to be, respectively, 1.34 J kg⁻¹ K⁻¹ and 71 J kg⁻¹ for a 1.5 T field change.

Bulk nanocrystalline samples of (La_1−xPr_x)_0.67Ba_0.33MnO₃ (0.075 ≤ x ≤ 0.30) manganites with a fixed carrier concentration are prepared by the sol–gel based Pechini method.     

Venetoclax and hypomethylating agents in FLT3-mutated acute myeloid leukemia

FMS-like tyrosine kinase 3 (FLT3) mutations are prevalent in acute myeloid leukemia (AML), and their presence confers adverse risk. FLT3-mutated (FLT3m) AML is a challenging leukemia to manage, particularly in older and unfit patients as well as patients with relapsed/refractory (r/r) disease. We retrospectively analyzed the outcomes of 50 FLT3m AML patients (17 treatment-naïve, 33 r/r) treated with venetoclax (VEN) and hypomethylating agents (HMA). The overall CR/CRi rate with VEN-HMA was 60% (94% in treatment-naïve AML and 42% in r/r AML). Early (60-days) treatment related mortality was 2%. The r/r AML setting was an independent predictor of lower complete response (OR: 0.08; 95%CI: 0.00-0.60, P = .03). Cytogenetics-molecular risk, concurrent mutations, the type of FLT3 mutation (ITD vs TKD), the ITD allelic ratio, the type of HMA, age, prior exposure to HMA and receipt of prior allogeneic transplant did not independently impact response or leukemia-free survival (LFS). Concurrent IDH mutations were associated with lower CR/CRi (P = .01), while ASXL1 or TET2 mutations showed a non-significant association toward higher CR/CRi (P = .07, for both). However, none of the concurrent mutations were an independent predictor for response when adjusted to AML setting. In conclusion, VEN-HMA is associated with encouraging efficacy in FLT3m AML among both newly diagnosed unfit and r/r patients.     

Therapeutic effects of proprioceptive exercise on functional capacity,anxiety, and depression in patients with diabetic neuropathy: a 2-month prospective study

Clinical Rheumatology - Diabetic neuropathy (DN) is a common and serious complication of diabetes. DN patients are suffering from anxiety, depression, and impairment of functional capacity. Rare...     

Neuromodulatory effects of green coffee bean extract against brain damage in male albino rats with experimentally induced diabetes

Metabolic Brain Disease - Diabetes mellitus is an increasing metabolic disease worldwide associated with central nervous system disorders. Coffee is a widely consumed beverage that enriched with...     

Sustained release and enhanced oral bioavailability of rivaroxaban by PLGA nanoparticles with no food effect

Journal of Thrombosis and Thrombolysis - The purpose of the currents study was to enhance bioavailability of rivaroxaban (RXB) and reduce the food effect. RXB loaded PLGA nanoparticles...